Indications and complications of secondary tracheoesophageal puncture in Chinese laryngectomees

Abstract

Background

Although there are many literatures about secondary tracheoesophageal puncture (TEP) for voice prosthesis. Most of the description of indications is not specific and the description of complications is not so vivid, which is not of great value for novice doctors.

Objective

To show specific indications and vivid complications of secondary TEP with typical clinical pictures for novice doctors.

Material and methods

The clinical data of 20 patients undergoing secondary TEP for Provox Vega voice prosthesis in our hospital were analyzed. The surgical indications and the prevention and treatment of common perioperative complications were summarized.

Results

The surgical indications included: no obvious stenosis of the stoma and the entrance of esophagus; no obvious scar constitution, mouth opening restriction and backward restraint of the neck, etc. The common postoperative complications included: TEP fistula infection (2 cases), bleeding of the fistula (1 case), deep neck abscess (1 case), granulation hyperplasia at the inner side of the fistula (1 case), invagination of the voice prosthesis (2 cases) and leakage (2 cases).

Conclusions and significance

The secondary TEP for Provox Vega voice prosthesis is clinically safe, but certain indications should be mastered. Common postoperative complications can be solved through preventive and remedial treatment schemes.

Chinese Abstract

背景：虽然有很多关于因发声假肢而进行二次气管食管穿刺（TEP）的文献。大部分适应症描述不具体, 并发症描述也不那么形象, 对新手医生来说价值不大。

目的：展示二次TEP的具体指征和形象的并发症, 为新手医生提供典型的临床表现图片。

材料与方法：对因Provox Vega 发声假肢在我院接受二次 TEP 的20位患者的临床资料进行了分析。总结手术适应症及围手术期常见并发症的防治。

结果：手术适应症包括：造口无明显狭窄, 食管;无明显瘢痕体质、张口受限及颈部后向受限等。术后常见并发症包括：TEP瘘管感染（2例）、出血瘘管内陷（1例）、颈深部脓肿（1例）、瘘管内侧肉芽增生（1例）、发声假体内陷（2例）、渗漏（2例）。

结论与意义：Provox Vega 发声假体的二次 TEP 临床是安全的, 但应掌握一定的适应症。常见的术后并发症都能通过预防和补救治疗方案得以解决。

Keywords:

• Secondary tracheoesophageal puncture
• Provox Vega voice prosthesis
• indications
• complications

Ethics approval and consent to participate

This study was approved by the Ethics Committee of the Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China. Signed informed consents were obtained from all patients included.

Author contributions

Chunping Wu: Conceptualization, Methodology, Formal analysis, Writing – Original Draft, Validation. Duo Zhang: Software, Validation, Investigation, Original draft preparation. Xiaohui Yuan: Software, Validation, Investigation. Ling Chen: Conceptualization, Methodology, Data Curation, Project administration. Lei Tao: Conceptualization, Methodology, Writing – Review and Editing, Project administration.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Funding was provided by the clinical three-year action plan of Shanghai Shenkang Hospital Development Center [No. SHDC2020CR6011].